Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 15125 | TN |
NPI | 1235482522 |
---|---|
Provider Name | Mrs. Allison Thornell West |
First Address | Millington, TN 38053-4930 |
Second Address | Memphis, TN 38104-3627 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2012 |
Last Update Date | 05/05/2020 |